THE WALTON CENTRE NHS FOUNDATION TRUST CLINICAL FELLOW IN NEUROSURGICAL NEURO-ONCOLOGY JOB DESCRIPTION

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1 THE WALTON CENTRE NHS FOUNDATION TRUST CLINICAL FELLOW IN NEUROSURGICAL NEURO-ONCOLOGY JOB DESCRIPTION GENERAL INFORMATION ABOUT THE LIVERPOOL AREA AND THE LOCAL REGION Liverpool is a dynamic city. It has experienced a major revival over the past few years and Merseysiders enjoy a superb quality of life. It is unusually compact and a journey to the centre rarely takes more than 30 minutes. The county abounds with fine architecture, lively cultural pursuits and outstanding sport. Tourism has become a major industry and 20 million people visited the city last year, attracted by both the areas natural and man made assets. Merseyside's theatres, museums and art collections are now amongst its strongest assets. The city is alive with independent theatre groups, authors, poets and dance groups. Photography, sculpture, street art and video makers abound. The Walker Art Gallery contains a collection of equal to any in the provinces and the Tate Gallery opened in 1988 on Liverpool's waterfront in the refurbished Albert Dock. The Philharmonic Orchestra is nationally acclaimed and there is a full range of musical activities of all types. There are both Anglican and Roman Catholic Cathedrals and facilities for worship for every other faith in the city. There are excellent schools for both sexes, including a variety of denominational schools for both in the private and state sector. The University Medical School and the Liverpool Medical Institution are within 20 minutes drive of the Walton Centre. Very good housing in pleasant suburbs near the sea and in rural areas are easily available, the cost of which is rather less than the national average. Two airports are within easy reach. Liverpool and Manchester International Airport are within half to three quarters of an hour s drive time. There are excellent train services and motorway links to all parts of the country, with easy access to the national parks, North Wales, the Peak District and the Lake District, as well as to both Lancashire and North Wales coasts. South Sefton is the home of the Grand National Racecourse at Aintree and also embraces the Freeport of Liverpool. There are several excellent nearby golf courses of which three host the Open Championship. In 2008 Liverpool will become the European City of Culture. 1

2 THE WALTON CENTRE NHS Foundation Trust The Walton Centre NHS Foundation Trust (WCFT) is an independent specialist neurosciences NHS Trust hospital providing a high quality, integrated and multidisciplinary neurosciences service to Merseyside, North Wales, the Isle of Man and part of West Lancashire which totals a population of 3.2 million. The Centre is adjacent to the Aintree University Hospital NHS Foundation Trust which is a busy District General Hospital Trust located 6 miles from the centre of Liverpool. The Centre is based in a purpose built building, opened in The Centre is virtually self contained and has 84 neurosurgical beds, 48 Neurological beds (including a day ward and a programmed investigation unit), and 4 pain relief beds. Critical care facility comprises an 18 bedded dedicated Neuro-Intensive Care Unit and a 4 bedded high dependency area. The centre is organised into three divisions; neurosurgery lies in the directorate of neurosurgery, critical care and anaesthesia and pain services. The other directorates comprise neurology and diagnostics. Activity There are almost 4000 neurosurgical admissions per annum and 3500 operations of which 450 are pain relief procedures. There are four fully staffed neurosurgical operating theatres and one Pain Relief operation theatre. An additional emergency theatre is available for a limited number of sessions per week. Outpatient clinics including specialised ones are held within the Centre; there are further clinics in surrounding hospitals including Chester, Whiston, and Wigan. Neurosurgical Staff In addition to the consultant staff there are 9 higher surgical trainees, 5 Clinical Fellows (including this post) and 6 SHOs (out of a pool of 15). Consultants currently in post and their special interests are: Prof PR Eldridge Mr Z Sarsam Mr AR Brodbelt GENERAL AND FUNCTIONAL NEUROSURGERY COMPLEX SPINE AND GENERAL NEUROSURGERY NEUROONCOLOGY, GENERAL, AND SPINAL NEUROSURGERY Mr TJD Pigott Mr R Pillay Mr PL May Mrs C McMahon Mr N Buxton GENERAL, SPINAL NEUROSURGERY SPINAL NEUROSURGERY SPINAL NEUROSURGERY TRAUMA AND HYDROCPEHALUS, SPINAL NEUROSURGERY 2

3 Miss K Gilkes Mr M Wilby Mr D Lawson Mr J Farah Mr M Teli Mr M Jenkinson Mr S Clark Miss A Visca GENERAL, SKULL BASE, STEREOTACTIC RADIOSURGERY GENERAL AND COMPLEX SPINAL NEUROSURGERY GENERAL NEUROSURGERY GENERAL AND FUNCTIONAL NEUROSURGERY SPINAL SURGERY NEUROONCOLOGY, HDYROCEPHALUS AND GENERAL NEUROSURGERY SPINAL SURGERY Vascular and skull base 3

4 Associated Services and Facilities 1. Neurology There are 30 Consultant Neurologists including 3 Professors, and 2 Senior Lecturers. The junior staff comprise 7 trainees at SPR level or equivalent and 9 SHO s. The SpR grades also work with Neurophysiology. The neurologists have special interests in epilepsy, movement disorders, muscle disease, demyelination, dementia and cerebrovascular disease. In addition to inpatient and outpatient work within the Centre clinics are held at most of the District General Hospitals served by the Centre. 2. Neuroradiology There are 6 Consultant Neuroradiologists and an SPR in neuroradiology. There are two rotating registrar posts and currently one externally funded neurointerventional fellow post. The Department is well equipped with a spiral CT scanner, a biplanar angiography suite, Two 3T, and one open 0.35T MR scanners,and myelography. 3. Neuropathology There are 2 Consultant Neuropathologists and a Specialist Registrar. Neurohistology, Neurochemistry and Cytology including Immunocytology are undertaken. 4. Neurophysiology There are 1.7 Consultant Neurophysiologists and 1 SPR. A complete neurophysiological service is available. 5. Neuro-anaesthesia There are 12 Consultant anaesthetists. A Consultant is in administrative charge of the Centre s dedicated ITU. Further support comes from four clinical fellows, 3 staff grades, and an associate specialist, and an SHO. It is planned to appoint two further WTE consultant. 6. Pain Relief The Regional Centre for Pain Relief is a multidisciplinary department run by 4 Consultants (including The Professor of Pain Science) and an Anaesthetic Specialist Registrar. Two of the neurosurgeons have close links with this department. There is further integration with the Pain Research Institute which is part of the University Department of Neuroscience. 7. Department of Clinical Neurosciences, University of Liverpool The University of Liverpool has links to the Clinical Sciences Centre adjacent to the Walton Centre on the University Hospital Aintree campus. This represents a partnership between WCNN, University Hospital Aintree, the University of Liverpool, Edge Hill University College and the Pain Relief Foundation. There are professors in Neurology, Pain Science, Neuropsychology and Magnetic Resonance Imaging. The University Department has an active programme of research and teaching. The WCNN and the University Department have also created a Clinical Trials Unit (CTU) where members of the Centre can undertake various clinical trials. The unit has a manager and team of nurses/secretaries to help in the participation of high quality trials. In addition the Pain Research Institute is able to provide research facilities for those with appropriate interests. Other University Departments and colleagues have shown themselves extremely willing to collaborate in joint programmes of research. Most members of the medical staff of the WCNN are actively involved in research and education. 4

5 Neurooncology Research There are links to a number of university laboratories, and a number of ongoing research projects. Funding for an NIHR research fellow has just been approved. There are research programmes into the molecular biology of neurological tumours, the relationship with advanced MR imaging, conformal radiotherapy, and stereotactic surgery, which provides opportunities for research. The clinical neurosurgeons hold honorary clinical lecturer appointments. and are active in research in their subspecialist fields. Mr Jenkinson is a senior lecturer at the University of Liverpool with a research programme in meningioma and metastases. Within the Walton Centre there is a purpose built Clinical Trials Unit, which is fully staffed and will undertake clinical trials research under consultant supervision. 8. Postgraduate Education The WCNN has a very active programme of postgraduate education with a regular weekly series of clinical meetings, lectures, journal clubs and neuropathology. The Centre s library is situated in the Clinical Sciences Centre. The new Clinical Sciences building contains an IT resource centre which will give access to appropriate software for medical research material, etc. This can also be accessed via the Centre s own IT system. The education facilities include a Lecture Theatre with a capacity of 225 equipped with the latest audio visual aids, video conferencing facilities, an exhibition facility and seminar rooms 9. Paediatric Neurosurgery Paediatric Neurosurgery is undertaken at the Royal Liverpool Childrens NHS Trust some 4 miles away, which also accommodates the paediatric neurology. There are joint specialist clinics at Alder Hey eg the Paediatric Neuro-oncology, Cranio-facial Surgery clinic. 10. Neuropsychology The department comprises three consultants and a number of assistants. The bulk of the work of the service is related to pain management and epilepsy but is available to support, as required, other areas. Help is provided for example in respect of neuropsychological outcomes following neurosurgical diseases. 11. Rehabilitation Medicine The service offers inpatient rehabilitation to patients with complex disability from across Cheshire and Merseyside. There are strong links to the major trauma centre, Neurosciences and acute trusts across the region, patients needs are catered for throughout their rehabilitation journey and prompt admission following medical/surgical stabilisation is facilitated. Each of our 5 units have a comprehensive multidisciplinary team enabling patients to optimise their abilities, independence and quality of life whilst receiving ongoing medical care and intervention. The hub unit is based at the Walton Centre, with 30 beds for those with hyperacute and supportive rehabilitation needs. A further 43 beds are provided at spoke units (Broadgreen Hospital 15, St Helen s Hospital 20, Clatterbridge Hospital 8, The Walton Centre 10) for patients able to participate in active rehabilitation programmes. 5

6 Neurosurgical oncology The Walton Centre for Neurology and Neurosurgery has a comprehensive neurooncology programme. The Centre manages approximately 450 tumours a year. The collaboration with Clatterbridge Centre for Oncology is a key part of this process. The diagnostic process is supported by good quality MR imaging and spiral CT are available on site including facilities for MR and CT perfusion imaging, MR spectroscopy and functional MR. A limited PET and SPECT facility is available at the Royal Liverpool. In addition, the centre possesses several stereotactic frames suitable for stereotactic biopsy with either CT or MR. There are good facilities for undertaking surgical resections including image guidance, operating microscopes, intraoperative ultrasound, and ultrasonic aspirators. An intraoperative neurophysiological monitoring service is available. Fluorescence-guided resection using 5ALA is part of the routine service. A new intraoperative MRI is due to be built over the next 24 months. There are three clinical neuro-oncologists all based at Clatterbridge Centre for Oncology (Drs Husband, Haylock and Shenoy) and two at North Wales Cancer Centre (Drs Soe and Niladri), who provide adjuvant treatment using radiotherapy and chemotherapy. All run weekly clinics at both Clatterbridge and the Walton Centre; all participate in neuro-oncology multi-disciplinary meetings, attended also by neurosurgeons managing tumour cases. In addition to conventional radiotherapy, a new LINAC based stereotactic radiosurgical service is delivered by collaboration between the neurosurgeons and neuro-oncologists at a new satalite radiotherapy unit adjacent to the Walton Centre. The service is further supported by 2.6 WTE neuro-oncology nurse specialists. The Post This post is designed for a senior neurosurgical trainee (ideally post-cct if a UK applicant). The neurosurgeons work in teams. The post is mainly attached to Mr Brodbelt and Mr Jenkinson but the successful applicant would be expected to work within the associated firm. The fellow is expected to participate in both the clinical activity of the firm, and to participate in research. It is anticipated that the timetable will be: AM PM Mon Ward round / ward work Attend AB out patient clinic Tue Theatre Theatre Wed Postgraduate Education WCNN/ Post operative ward round/ Research Thu Glioma OPD / Audit / MDT meeting Stereotactic Radiosurgery Fri Theatre Theatre On Call The postholder will take part in registrar on call for adult (WCFT) neurosurgery. On call for the walton centre is a resident shift based system. On call is compliant with both EWTD and BMA guidelines on junior doctor s hours of work. At present there is a two tier on call for the most junior registrar, with a second senior registrar available. 6

7 Educational Approval The 10 Specialist Registrar posts in neurosurgery have been approved for Higher Surgical Training in Neurological Surgery by the Specialist Advisory Committee in Neurological Surgery and Joint Committee on Higher Surgical Training of the Royal College of Surgeons. The neuro-oncology fellow post has been approved for training by the SAC, PMETB, and Mersey Deanery. 7